METHODS: To address this gap, we conducted a cross-sectional study to examine the mental health of 455 SGD persons in Kazakhstan’s three cities—Almaty, Nur-Sultan, and Shymkent, and its association with COVID-19 disruptions of HIV testing and treatment services. We used follow-up assessment data, collected from May through October of 2020, from the UNI Project, a NIDA-funded clinical trial of a social network-based intervention for increasing linkage to the HIV care continuum. The exposure variable, COVID-19 disruptions to accessing HIV-related services, assessed whether respondents ever experienced limitations in their ability to receive HIV testing or treatment due to COVID-19 (1=yes, 0=no). For response variables, DASS-21 (Henry & Crawford, 2005) subscales were used to measure emotional states of depression, anxiety, and stress. We applied linear regression analysis, adjusting for confounding effects of age, employment, gender, and sexual orientation.
RESULTS: Mean scores on DASS-21 subscales were 9.2, 8.2, 11.9 for depression, anxiety, and stress, respectively. These scores also indicated that 30.3% (n=138), 36.9% (n=168), and 17.6% (n=80) of the sample experienced at least moderate levels of depression, anxiety, and stress, respectively. In multivariable analyses, each of the DASS-21 subscales was significantly positively associated with endorsing COVID-19 disruptions in the ability to get HIV testing or treatment: depression (b(SE)=4.43(1.44), 95%CI=1.59-7.26, p=.002), anxiety (b(SE)=4.51(0.99), 95%CI=2.56-6.46, p<.001), and stress (b(SE)=4.13(1.20), 95%CI=1.78-6.48, p=.001).
CONCLUSIONS AND IMPLICATIONS: Findings are consistent with the worsening of psychological distress in the presence of the negative impacts of COVID-19 and COVID-19 mitigation measures on the ability of SGD persons in Kazakhstan to engage in the HIV care continuum. Programs that promote mental health among SGD persons may be valuable and have synergistic benefits for a population grappling with both COVID-19 and HIV in Kazakhstan.